ADHD in Teens: Signs, Symptoms, & Treatment

What Is ADHD?

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by lasting patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning and development.¹

Symptoms of ADHD often begin in childhood, but parents and caregivers may not distinguish these symptoms from typical age-appropriate behavior until adolescence. Depending on the type of ADHD, children and teens with ADHD struggle with different challenges across their relational, academic, and personal lives.

The types of ADHD include:

• Inattentive: Inattentive ADHD may appear as poor concentration, distractibility, and poor organization skills.
• Hyperactive/impulsive: Those with hyperactive/impulsive ADHD struggle with “turning off.” They may have abundant energy, leading many to fidget, appear restless, or talk over others.
• Combined: A person with combined ADHD exhibits symptoms from both inattentive and hyperactive/impulsive ADHD.

ADHD Symptoms in Teens

Like with any mental health condition, ADHD symptoms in teenagers vary based on several personal and environmental factors. Teens with ADHD may appear withdrawn from others, easily distractible, or self-absorbed. Some may be particularly reactive to rejection, contributing to low self-esteem and social challenges.

While these behaviors can resemble typical adolescent demeanor, ADHD symptoms occur across various situations and meet specific diagnostic criteria. Everyone experiences neurodiversity differently, but parents can look for recognizable signs of ADHD in their children.

Common symptoms of ADHD in teens include:²

• Chronic procrastination: Chronic procrastination can look like delaying assignments until the last moment. Teens may then feel overwhelmed by the amount of work they must complete in a brief period.
• Impulsivity: Impulsivity can present in many forms, including compulsive behavior with drugs, sex, alcohol, food, or shopping.
• Maladaptive daydreaming: Maladaptive daydreaming refers to excessive daydreaming that disrupts everyday life.
• Rejection-sensitive dysphoria (RSD): RSD in ADHD refers to an intense fear of criticism. Teens with ADHD may exhibit extreme reactions to feedback, even when constructive.
• Difficulty with social cues: Teens with ADHD may struggle with the nuances of nonverbal communication and various social norms.
• Emotional outbursts: Teens may experience emotional outbursts or fits of anger if they have unmet needs or feel overwhelmed. This is sometimes called ADHD meltdowns.
• Troubles with transitions: ADHD can make going with the flow or coping with sudden transitions difficult, particularly when ending an enjoyable activity.
• Difficulty following directions: ADHD can cause problems with memory, focus, and attention to detail, especially when receiving detailed or complicated instructions.
• Feeling constantly “on the go”: Some teens may appear restless and fidgety as if wound by a motor. Some may exhibit abundant energy, whether engaging in conversations, physical activities, or personal interests.
• Self-focused behavior: Some teens with ADHD may appear self-focused because they struggle with memory. For example, they may forget about birthdays, anniversaries, or other important dates.
• Difficulties staying organized: Disorganization is a common ADHD symptom, often resulting in lost assignments or items.

How Common Is ADHD in Teens?

Research shows the overall lifetime prevalence of ADHD is 8.7%, with boys receiving a diagnosis far more frequently than girls. The median age of onset for moderate ADHD is six, although symptoms can manifest earlier in some children.³

Does ADHD Get Worse With Puberty?

Puberty can be a difficult, tumultuous time for all adolescents and their families. In the case of navigating ADHD and puberty, teens may experience exacerbated and heightened symptoms. They may be more prone to impulsivity, irritability, and low self-esteem. In addition, the pressures associated with school and friendships can intensify these symptoms as teens attempt to adhere to social expectations and norms.

ADHD Symptoms in Teen Girls vs. Boys

In many cases, ADHD in teen girls differs significantly from that in boys. ADHD symptoms in teen boys are often more pronounced and impulsive, making the condition more readily recognizable by others. Conversely, teen girls often experience more inattentive symptoms and difficulties with organization and staying on task. Because of these discrepancies, teenage boys more frequently receive an ADHD diagnosis than their female peers.⁴

Signs of ADHD in Teens

Overlooking or misinterpreting signs of ADHD in teens can be easy. Parents and teachers may dismiss certain behaviors as the teen simply being lazy, defiant, or disorganized. While most ADHD symptoms emerge in early childhood, more noticeable manifestations only become more apparent during adolescence. Therefore, caregivers should educate themselves to understand the most common signs of ADHD in their teens.

Below are common signs of ADHD in teens:

• Frequently interrupting conversations
• Fidgeting at their desk during school
• Frequently losing homework assignments
• Being unable to complete homework or study effectively
• Excessively talking
• Seeming to act without thinking
• Exhibiting little or no sense of danger
• Sensitivities to certain sensations, noises, and emotions
• Difficulty with managing time
• Difficulty navigating transitions

How Does ADHD Affect Teens in Daily Life?

Teenagers with ADHD face unique challenges with daily activities in school, home, and relationships. Many have difficulty with emotional regulation and executive dysfunction, which can impact their ability to manage impulsivity and attention span.

Because disruption and change riddle adolescence, symptoms of ADHD can make coping with these shifts especially challenging. Parents should consider seeking professional advice if their teen continues to exhibit difficulties with maintaining relationships, has difficulties managing ADHD in the classroom, engages in substance misuse, or struggles with frequent mood swings.

Difficulties With Peer Relationships

Teenagers with ADHD may experience problems making and maintaining friendships, possibly due to difficulties with emotional regulation, verbal impulsivity, or hyperfocus. Alternatively, they may experience low self-esteem or social anxiety that affects their ability to enjoy these relationships, even if they have a positive support system.

Increased Risk of Car Accidents

While teenagers are already at a heightened risk of car accidents, driving with ADHD makes people especially vulnerable to reckless driving. Several factors may contribute to this influx, including daytime fatigue, impulsivity, poor concentration, distractibility, and inattention.⁵

Risky Behaviors

ADHD often goes hand-in-hand with impulsivity and executive dysfunction, meaning teenagers with ADHD may be at risk of impulsive behaviors. While such actions exist on a large spectrum, they can include drug experimentation, violence, sexual aggression, dangerous driving, unsafe sexual practices, shoplifting, and more.

Alcohol Misuse

Alcohol is the most widely used substance among American teenagers, and underage drinking is a rampant problem. In 2022 alone, about one in five teenagers ages 14-15 reported having at least one drink in their lifetime.⁶

However, teens with ADHD may be at a higher risk of alcohol misuse. Because of impulsivity and poor decision-making skills, they may be prone to unhealthy habits like binge drinking or driving under the influence.

Poor Academic Performance

At times, the traditional school setting can feel incompatible with ADHD symptoms like restlessness, compromised attention span, and poor concentration. Many teenagers with ADHD also struggle with organization and other tasks essential for completing homework or studying effectively for exams, affecting their academic performance and grades.

Emotional Dysregulation

Emotional dysregulation is a persistent difficulty with interpreting and processing emotions. In turn, teens with ADHD may be more prone to severe depression, anger outbursts, self-harm, or suicidal thoughts. This phenomenon appears closely connected to difficulties with executive function, which is a core feature of ADHD.

Comorbid Mental Health Conditions

Many teenagers with ADHD also meet the criteria for other co-occurring mental health disorders, including mood disorders, anxiety disorders, eating disorders, personality disorders, and substance use disorders. While experts do not believe one condition causes the other, they can certainly exacerbate each other.

Medication Misuse

Many children and teenagers take stimulants to manage ADHD symptoms. Teens who use these medications as prescribed by their pediatrician can benefit from stabilized emotions and concentration. However, stimulant misuse is possible, possibly leading to dependence and addiction. A family history of addiction or other co-occurring mental health issues can increase the risk of abuse.

How to Get Diagnosed With ADHD as a Teenager

Diagnosing ADHD in teenagers often includes personal and caregiver interviews and a review of past and current symptoms. While professionals do not have a specific ADHD test for teens, various assessments can provide insight to distinguish symptoms from other conditions, such as teenage depression or teenage anxiety.

The DSM-5 criteria for ADHD in teens include:

• Symptoms must be present for at least six months
• Signs and symptoms are not developmentally appropriate
• Current symptoms must occur in two or more settings
• Symptoms impact daily functioning
• Symptoms do not result from other mental health conditions
• Symptoms were present before age 12

For teens under the age of 16, the criteria include:

• At least six symptoms of inattention
• At least six symptoms of hyperactivity-impulsivity

For teens over the age of 17, the criteria include:

• At least five symptoms of inattention
• At least five symptoms of hyperactivity-impulsivity

ADHD Treatment for Teens

Coping with ADHD in adolescence poses many challenges. Treatment for ADHD can make a difference in how your teen functions in their daily life. Of course, treatment is not a “one size fits all” approach to managing symptoms. You and your child will likely experience trial and error when finding the best plan. Comprehensive approaches for ADHD generally include both medication and talk therapy, with providers working together to strive for positive outcomes.

Medications

ADHD medications for teenagers can improve focus and reduce impulsive behavior. Stimulants are a first-line treatment for ADHD and work by increasing dopamine, helping teens remain alert, focused, and engaged. However, stimulants come with the risk of dependency, and many parents may pursue information about alternatives.

Non-stimulant medications are another beneficial treatment for ADHD without the risk of addiction. These prescriptions are also helpful for those who react poorly to traditional stimulants. Consult a doctor or pediatrician about available options, possible adverse effects, and dosage guides.

Common ADHD meds for teens include:

• Adderall (amphetamine)*
• Vyvanse (lisdexamfetamine)*
• Strattera (atomoxetine)
• Evekeo (amphetamine)*
• Ritalin (methylphenidate hydrochloride)*

* This medication has a black box warning, the most serious kind of warning from the FDA for a risk of medication misuse or abuse.

Therapy

Therapy offers teens living with ADHD space and opportunities to understand their diagnosis. Therapists can help them address impulsivity, overwhelm, symptoms of anxiety, and depression as they navigate the challenges of adolescence.

Finding a neurodiversity-affirming therapist is essential because these individuals understand the nuances of ADHD. Providers specializing in teen issues can also provide parents with much-needed guidance for approaching topics like puberty, drug misuse, and sex. Support is available, and having the nonbiased advice of a professional can improve the lives of teens with ADHD.

Therapy options for ADHD symptoms in teens include:

• Cognitive behavioral therapy (CBT): CBT for ADHD focuses on the relationship between thoughts, feelings, and behaviors. A CBT therapist can help teens change negative thought patterns via cognitive restructuring, thought-stopping, and other behavioral strategies.
• Dialectical behavior therapy (DBT): DBT integrates concepts of mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. Techniques from these modules can help stabilize ADHD symptoms.
• Motivational Interviewing (MI): MI may be used when teenagers exhibit impulsive behavior or show signs of ambivalence about change.
• Family therapy: Family therapy can be effective for parents and other family members to learn how to support their teen’s ADHD effectively.
• Mindfulness-based CBT (MBCT): MBCBT blends mindfulness with behavioral techniques to help people feel more empowered and emotionally-regulated.

How to Cope With ADHD as a Teenager

While navigating ADHD can be scary, self-care for teens can go a long way. Teenagers with ADHD should feel empowered to establish autonomy and develop confidence as they approach their new diagnosis. Adopting healthy sleep, diet, and exercise routines can add stability to their lives while engaging in pro-social activities can promote positive relationships and self-esteem.

Here are 10 ways to cope with ADHD symptoms as a teen:

1. Limit your screen time: Excessive screen time may adversely affect attention span. Setting boundaries around screen time can help increase productivity, particularly with schoolwork and social obligations.
2. Get involved in enjoyable activities: Engaging in meaningful activities can be an important part of self-care, and finding joy in such hobbies can help improve self-esteem.
3. Maintain healthy sleep hygiene: Many people with ADHD struggle with sleep-related issues, whether sleeping too little, staying up late, or maintaining inconsistent sleep routines. As much as possible, aim to go to bed and wake up at the same time each day to improve sleep hygiene.
4. Establish healthy eating patterns: Focus on eating regular and healthy meals with plenty of fruits, vegetables, and protein. Good nutrition can improve your overall mental and physical well-being.
5. Create simple daily routines: People with ADHD often thrive when they can follow a routine, so try to adhere to a basic schedule to keep yourself on track.
6. Identify a peaceful space: Create a calming environment free (or mostly free) of clutter. Retreat to this space to focus on important tasks (like homework) or when you feel overwhelmed.
7. Brain dump when overwhelmed: Sometimes, venting your thoughts to a safe person or brain-dumping with a journal can help remove distractions from your brain.
8. Spend time outdoors: Nature can be relaxing and help evoke a sense of calm during the day. Consider spending time outdoors when feeling stressed or overwhelmed. Even better, implement outdoor activities into your daily routine to boost overall well-being.
9. Explore your hobbies: Prioritize trying new interests if you do not currently have a hobby. Remember, you don’t have to be good at something to enjoy yourself.
10. Ask for help when needed: Reach out for support when struggling. Talk to your parents, teacher, or therapist, as these individuals can provide helpful guidance, resources, and accommodations.

How to Help a Teen With ADHD

Offering support to a teen navigating ADHD can be invaluable as they age through adolescence. Parents and caregivers can create a healthy environment by remaining open, empathetic, and encouraging, especially when their teen might feel alone. Remember, the support your teen needs may change daily, and being flexible ensures your teen continues to feel accepted and appreciated.

Below are ways to support a teen with ADHD:

• Reward positive behaviors: Reinforce positive behaviors via praise and appropriate incentives. However, be mindful of creating a dynamic where love feels conditional (earned) rather than unconditional (inherent and without expectations).
• Ask what they need from you: Don’t automatically assume you understand how your teen wants support. Ask if they want advice, practical support, or emotional compassion when they experience difficulties.
• Actively listen when they communicate their experience: Listen to your teen as they share their feelings, ensuring to validate their needs. Kids with ADHD often face unique challenges because of their diagnosis, so try to understand their viewpoint.
• Be flexible when their needs change: Avoid rigid thinking and adapt to their changing developmental needs as they pass through adolescent milestones.
• Set time aside to discuss their challenges: Let your teen know you want to collaborate on the best solutions for supporting them. Show them you care about their difficulties and are a safe space.
• Encourage them to seek extracurricular activities: Highlight the benefits of meaningful hobbies. Be a good role model by engaging in your own interests.
• Support them through treatment: Stay involved with their therapist and psychiatrist while respecting their privacy.
• Separate them from their diagnosis:  Remember, your teen is unique and has wonderful strengths and assets. ADHD is simply a diagnosis, not their entire identity.